Audience:
- All histocompatibility Primary Lab Directors and Primary Data Coordinators
- All transplant Primary Program Administrators and Primary Data Coordinators
- All Primary OPO Administrative Directors and Primary OPO Medical Directors
- Members of the OPTN Histocompatibility Committee
- All OPTN Representatives and Alternate Representatives
- Please share this notice with anyone in your organization who would benefit from it
Implementation date
June 17, 2021
At-a-glance
At its June 2020 meeting, the OPTN Board of Directors approved the recommendation from the Histocompatibility Committee to update Policy 4.10: Reference Tables of HLA Antigen Values and Split Equivalences. This will result in changes to HLA and unacceptable antigen options as well as the equivalencies used for HLA matching and screening of unacceptable antigens between candidates and donors.
- These changes include certain B and DR matching equivalences, certain B, C, DR, DPB1 unacceptable alleles, a new epitope-based assignment for DPB1 unacceptable alleles, update of DPB1 reportable antigens, and removing one DQB1 antigen.
- These changes will occur in DonorNet®, Waitlist℠, TIEDI® and KPD℠ applications. The “All Other Antibody Specificity” fields in KPD will also be affected.
- B 07:03
- B 27:03
- B 83:01
- C 03:05
- C 04:04
- C 04:07
- C 05:01
- C 06:02
- C 07:06
- C 07:18
- C12:04
- C 15:04
- C 15:06
- C 15:09
- C 16:04
- DR 103
In addition, DQB1 1 will be removed in the HLA and unacceptable antigen section throughout UNet℠, including the KPD other antibody specificity section.
Refer to the policy notice to see the equivalency changes that will affect donor to candidate screening and matching.
Other changes you will see throughout UNet
In the Waitlist and KPD unacceptable antigen sections, there will be a separate option to select DPB1 epitopes. Selecting an unacceptable epitope results in a number of donor equivalences that will be used to screen against candidates.
The reportable list of DPB1 unacceptable antigens differs from the reportable DPB1 HLA, so refer to the policy notice for the full list and all epitope based matching equivalences.
Additionally, Calculated Panel Reactive Antibody (CPRA) scores for kidney, pancreas and kidney-pancreas, and KPD candidates may change.
- On June 17, we will update the Waitlist and OPTN CPRA calculators to include the unacceptable antigen changes.
- If you use your own CPRA calculator, you will need to update it to be in sync with UNet calculation.
How to import DPB1 Epitopes in Waitlist Import Unacceptable Antigen Utility
With the addition of the new DPB1 epitopes, the following format should be used to import into Waitlist:
- DPB55EAE, DPB55DED, DPB55DEE, DPB84DEAV, DPB84GGPM, DPB84VGPM
Additional information
The Histocompatibility Committee must annually review and recommend any changes needed to the tables. The proposed changes to the equivalency tables are intended to reflect changes in HLA typing practice and improve organ allocation.
Policy resources
- To view the updated Antigen Equivalence tables in detail, consult Policy 4: Histocompatibility on the OPTN website.
- The policy notice HLA Equivalency Table Updates 2020 (Including Expedited Pathway for Future Updates contributed to these system changes.
Questions
If you have questions relating to implementation, contact UNOS Customer Service at [email protected], or call 800-978-4334 from 8 a.m. to 7 p.m. ET.
For policy-related questions, contact [email protected].
The Organ Center is available 24 hours a day at 800-292-9537.
